Avoid Dying Before Your Time

Smoking, high blood pressure and being overweight are the leading preventable risk factors for premature mortality in the United States, according to a new study led by researchers at the Harvard School of Public Health (HSPH), with collaborators from the University of Toronto and the Institute for Health Metrics and Evaluation at the University of Washington. The researchers found that smoking is responsible for 467,000 premature deaths each year, high blood pressure for 395,000, and being overweight for 216,000. The effects of smoking work out to be about one in five deaths in American adults, while high blood pressure is responsible for one in six deaths.

It is the most comprehensive study yet to look at how diet, lifestyle and metabolic risk factors for chronic disease contribute to mortality in the U.S. The study appears in the April 28, 2009 edition of the open-access journal PLoS Medicine.

"The large magnitude of the numbers for many of these risks made us pause," said Goodarz Danaei, a doctoral student at HSPH and the lead author of the study. "To have hundreds of thousands of premature deaths caused by these modifiable risk factors is shocking and should motivate a serious look at whether our public health system has sufficient capacity to implement interventions and whether it is currently focusing on the right set of interventions." Majid Ezzati, associate professor of international health at HSPH, is the study's senior author.

The researchers also found large effects from a series of other preventable dietary and lifestyle risk factors. Below are the numbers of deaths in the U.S. due annually to each of the individual risk factors examined:

Smoking: 467,000
High blood pressure: 395,000
Overweight-obesity: 216,000
Inadequate physical activity and inactivity: 191,000
High blood sugar: 190,000
High LDL cholesterol: 113,000
High dietary salt: 102,000
Low dietary omega-3 fatty acids (seafood): 84,000
High dietary trans fatty acids: 82,000
Alcohol use: 64,000 (alcohol use averted a balance of 26,000 deaths from heart disease, stroke and diabetes, because moderate drinking reduces risk of these diseases. But these deaths were outweighed by 90,000 alcohol-related deaths from traffic and other injuries, violence, cancers and a range of other diseases).
Low intake of fruits and vegetables: 58,000
Low dietary poly-unsaturated fatty acids: 15,000

All of the deaths calculated in the study were considered premature or preventable in that the victims would not have died when they did if they had not been subject to the behaviors or activities linked to their deaths.